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Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery
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Study Design

Case Report.

Objective

To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.

Method

A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal split ramus osteotomy performed five years earlier, which resulted in aseptic bone necrosis on the right side. The patient had marked mandibular deviation, chin and midface retrusion and a pronounced occlusal discrepancy. Imaging demonstrated a bony defect at the right mandibular angle with a superiorly displaced proximal segment. Deviation of the mandible was corrected first by performing vertical ramus subsigmoid osteotomy (RSO) on the left side. The right bone defect was then reconstructed with a reconstruction plate and bone grafting. Maxillary and chin advancement was performed at a second stage.

Results

On follow-up, the patient shows a significant improvement in facial esthetics and mandibular symmetry and is currently under orthodontic management to enhance the occlusal relationship.

Conclusion

Bone necrosis is a rare but dreaded problem in orthognathic surgery. Minimizing the musculo-periosteal dissection and competent execution of the bone osteotomy is substantially effective in reducing the risk of bone ischemia and necrosis.

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Publication Date
Thu Oct 30 2025
Journal Name
Folia Medica
Chronic Granulomatous Disease in Pregnancy: a Rare Case Report
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Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder that is either X-linked or autosomal recessive and is characterized by recurrent infections. The diagnosis is primarily based on the nitroblue tetrazolium dye reduction test. Here, we present the case of a 28-year-old pregnant woman with CGD who was diagnosed before marriage and who presented with recurrent subcutaneous skin and ocular infections. Following treatment with multiple antibacterial agents, including meropenem, her infections resolved, and she gave birth to a healthy baby girl at term. However, the newborn has now started to exhibit similar symptoms to those experienced by her mother. This case highlights the need for further studies on the potent

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Publication Date
Sun Jan 01 2023
Journal Name
Cerebral Ventricles
Third Ventricle: Surgery
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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Development of Sinusitis After Sinus Floor Elevation Surgery: A Systematic Review
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Background: Maxillary sinusitis can arise after sinus floor elevation surgery and should be treated immediately to prevent further complications which included dental implants failure, graft lost, and oro-antral fistula. This is the first systematic review to assess the incidence, causes, and treatment of sinusitis after sinus lift surgery. Materials and methods: An electronic search included MEDLINE (PUBMED) data base site was carried out for articles involving development of sinusitis after sinus lift surgery from September 1997 up to April, 8, 2017. The search was done and reviewed by two independent authors. Results: The total results of electronic search were (182) abstracts and articles, the extracted articles which involved develo

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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
Minimum Neighborhood Domination of Split Graph of Graphs
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Let  be a non-trivial simple graph. A dominating set in a graph is a set of vertices such that every vertex not in the set is adjacent to at least one vertex in the set. A subset  is a minimum neighborhood dominating set if  is a dominating set and if for every  holds. The minimum cardinality of the minimum neighborhood dominating set of a graph  is called as minimum neighborhood dominating number and it is denoted by  . A minimum neighborhood dominating set is a dominating set where the intersection of the neighborhoods of all vertices in the set is as small as possible, (i.e., ). The minimum neighborhood dominating number, denoted by , is the minimum cardinality of a minimum neighborhood dominating set. In other words, it is the

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Publication Date
Wed Oct 31 2018
Journal Name
Al-kindy College Medical Journal
Leigh Syndrome: Report of a Rare Case with Late Onset Presentation
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Leigh's syndrome, or sub acute necrotizing encephalomyelopathy, is a rare inherited neurometabolic disease of infancy and early childhood with variable course and prognosis. Rarely, it occurs in juveniles and adults. The diagnosis is difficult and still remains to challenge the clinicians on the basis of history; hence the role of imaging is very essential. It is the neuroimaging, chiefly the Magnetic Resonance Imaging showing characteristic symmetrical necrotic lesions in the basal ganglia and/or brain stem that leads to the diagnosis. Late-onset varieties are rare and only few cases were reported all over the world. Here, I report a case of late onset (juvenile) Leigh syndrome presenting with an acute polyneuropathy. Neuroimaging confi

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Publication Date
Mon Jan 01 2018
Journal Name
Indian Journal Of Public Health Research & Development
Histopathological alternations of placenta in pregnancy women complicated with gestational diabetes
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Publication Date
Thu Nov 01 2018
Journal Name
Indian Journal Of Public Health Research & Development
Histopathological changes of placenta in pregnant women complicated with pregestational diabetes
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Scopus
Publication Date
Wed Dec 15 2021
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Recipient Jaw and Implant Dimensions on Pre- and Post- Loading Dental Implant Stability: A Prospective Clinical Study
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Background: Implant stability is a mandatory factor for dental implant (DI) osseointegration and long-term success. The aim of this study was to evaluate the effect of implant length, diameter, and recipient jaw on the pre- and post-functional loading stability. Materials and methods: This study included 17 healthy patients with an age range of 24-61 years. Twenty-two DI were inserted into healed extraction sockets to replace missing tooth/ teeth in premolar and molar regions in upper and lower jaws. Implant stability was measured for each implant and was recorded as implant stability quotient (ISQ) immediately (ISQ0), and at 8 (ISQ8) and 12 (ISQ12) weeks postoperatively, as well as post-functional loading (ISQPFL). The pattern of implant

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Publication Date
Fri May 15 2026
Journal Name
Al-rafidain J Med Sci.
Prenatal Diagnosis of a Rare Dicephalic Parapagus Twin at 21 Weeks: A Case Report
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Dicephalus parapagus twinning (DPT) is the rarest conjoined twinning entity of all conjoined twins. The presence of DPT is always associated with mortality before or after delivery. Antenatal diagnosis is crucial for planning labor, assembling a team, and providing counseling. Case presentation: A 23-year-old patient (G2P1A0) at 21 weeks of pregnancy attended the ultrasound clinic for routine care. A monoamniotic-monochorionic pregnancy was observed; the twin fetuses had two heads but one body, which corresponded to dicephalus parapagus twinning. A detailed ultrasound and fetal echocardiography reveal one heart without congenital anomalies. The liver, kidneys, and bladder appeared to be normally developed. Fetal MRI and karyotyping wer

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Publication Date
Tue Jun 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Validity of computed tomographic in assessment of genial tubercle and anterior mandible as a reference guide to locate osteotomy in genioglossus advancement
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Background: Genioglossus advancement is a surgical procedure to advance the tongue in some patients with obstructive sleep apnea syndrome.The important step in this procedure is that of accurately capturing the bone segment attached to the genioglossus muscle to avoid complications such as mandibular fracture, devitalization of the inferior incisor roots, and incomplete incorporation of the genioglossus Materials and Method: Computed tomography scans were taken for 53 Iraqi adult patients (28 male and 25 female) range from (18-35) years with skeletal class I classification and intact anterior mandible dentition included in this study using sagittal and axial sections. The measurements were done for genial tubercle and anterior mandibular re

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